Why we have right to criticise how NHS Direct works

Dr Jay Nathan's letter was headlined 'Try working for NHS Direct first before you criticise' (February 17). Doctors who criticise NHS Direct are, I would assume, experienced in the triage of patients in the setting of a well-run co-operative. We fully 'comprehend the complexity involved in history taking and assessment over the telephone'. I do it for 12 hours a month at the co-op, and daily at my surgery.

Of course 'not all clinical decisions are straightforward' ­ is that an

excuse for NHS Direct doing its job badly?

It is perplexing that Dr Nathan does not blame the software for the failure ­ at least this would not be the fault of the nurses on the phone ­ but insists 'the final decision is determined by....judgment'. Does he admit, then, that they are not able to do the job as well as doctors?

NHS Direct deals with emergencies 'without the advantage of being able to examine the patient'. Precisely.

Co-operatives do have this advantage.

How do GPs 'pass the buck' when in doubt? In the context of out-of hours triage, I am entirely responsible for my own decisions.